Download injecting drug use is associated with high risk sexual practices and

INJECTING DRUG USE IS ASSOCIATED WITH HIGH RISK SEXUAL
PRACTICES AND SEXUALLY TRANSMISSIBLE INFECTIONS AMONG GAY
MEN: AN ANALYSIS OF BEHAVIOURAL AND EPIDEMIOLOGICAL DATA
Callander D1,2†, Lea T2†, Prestage G1,3, Fairley C4, Ryder N5, Grulich A1, Hellard, M6,
Mao L2, Holt M2, Guy R1
1
Kirby Institute, UNSW Australia, Sydney NSW
Centre for Social Research in Health, UNSW Australia, Sydney NSW
3
Australian Research Centre in Sex, Health and Society, La Trobe University,
Melbourne VIC
4
Melbourne Sexual Health Centre, Melbourne VIC
5
Pacific Clinic, Newcastle Community Health Centre, Newcastle NSW
6
Burnet Institute, Melbourne VIC
2
Introduction: Among gay men, drug use is associated with increased risk for
acquiring sexually transmissible infections (STIs). Little is known, however, about
injecting drug use among gay men, including if those who inject are at greater risk of
infection. We analysed injecting drug use among gay men and explore its
relationship to STIs.
Methods: Data were sourced from two national surveillance projects: an annual
survey of gay men (Gay Community Periodic Survey [GCPS]) and a network of 44
Australian sexual health clinics (Australian Collaboration for Coordinated Enhanced
Sentinel Surveillance of STIs and BBVs [ACCESS]). Logistic regression was used to
assess behavioural covariates of injecting among GCPS participants. In ACCESS
sample, incidence of an STI infection (chlamydia, gonorrhoea, or infectious syphilis)
was calculated annually using repeat testing; a Cox regression assessed incidence
covariates.
Results: From 2007-2015, there were 65,617 GCPS participants and 64,618 gay
men who attended ACCESS clinics, of which 2,938 (5%) and 2,266 (4%),
respectively, reported injecting drug use. After controlling for demographic factors
including HIV status, injecting drug use among GCPS participants was associated
with condomless anal sex with casual partners (adjusted odds ratio=1.5, 95%
confidence interval [CI]:1.1-2.0, p=0.009). In the ACCESS sample, after controlling
for demographic and behavioural factors (condom use, partner numbers), injecting
drug use was associated with STI incidence (hazard ratio=1.2, 95%CI:1.1-1.4,
p=0.001). From 2007 to 2015, the incidence of STIs increased among gay men not
reporting injecting (14.7-34.9, p<0.001) but was higher overall and increased to a
greater degree among injecting drug users (20.0-74.4/100PY).
Conclusion: Injecting drug use is associated with high risk sexual practices among
gay men and increased incidence of STIs. Given the nearly fourfold increase in STIs
among gay men who inject, prevention campaigns targeting this population are
urgently needed.
Disclosure of Interest Statement: None to declare.